Klin Farmakol Farm. 2016;30(3):33-36 | DOI: 10.36290/far.2016.028

Amiodaron: a good servant, but a bad master. Case report of amiodarone induced thyrotoxicosis with fatal outcome

Viktor Talafa¹, Ondřej Zela¹, Dalibor Pastucha², Petra Šrubařová¹

¹ Interní oddělení nemocnice ve Frýdku Místku, p. o.

² ReFit Clinic, s. r. o., Olomouc a Ústav rehabilitace lékařské fakulty Ostravské univerzity

The case report showcases a complication of amiodarone treatment – type 2 amiodarone induced thyrotoxicosis (AIT) with a fatal outcome. A 79-year old patient was being treated with the culprit drug for paroxysmal atrial fibrillation. The treatment was complicated by an atypical clinical presentation of AIT with altered mental status, qualitative change of consciousness and heart failure resulting in cardiac arrest. A successful CPR was performed and the patient was put on mechanical ventilation. An aggressive course of thyrostatic treatment along with corticosteroids was started early on. Due to little to no clinical or laboratory response an urgent thyroidectomy with tracheostomy was performed as a last resort. Having at last reached euthyroid state, the thyroid hormone replacement therapy was started. A series of post-operative complications emerged including relapsing ventilator- associated pneumonia. The patient was ultimately weaned off the ventilator support and sedation but deep impairment of consciousness persisted (persistent vegetative state). Subsequent prolonged intensive care led to progressive deterioration of overall condition and multiple organ dysfunction syndrome developed. Death occured after a total of 72 days of hospital stay.

Keywords: amiodarone, hyperthyreosis, thyrotoxicosis, thyreostatics

Published: December 1, 2016  Show citation